The long-term objective of the Patient-Defined Culturally Sensitive Health Care Research Project is to provide a theory-based patient- involved model for defining, assessing, teaching, and evaluating the effects of teaching health care providers "patient-defined" rather than "expert-defined" culturally sensitive health care. This research project has six Parts: (I) using focus groups for mostly low SES Hispanic American patients, Black American patients, and White American patients who attend community public health clinics to identify specific physician behaviors and health care environment variables that they perceive as indications of being culturally sensitive; (II) using this patient feedback to construct three ethnic-specific culturally sensitive health care inventories (one for each above specified ethnic group) for measuring patient- perceived cultural sensitivity in health care received, and then establishing the reliability and validity for each of these inventories and of each of the versions of these inventories that physicians can use to self- evaluate their level of perceived cultural sensitivity in the health care that they provide; (III) determining the associations between patients' perceived levels of cultural sensitivity in the health care that they receive and their ethnicity, acculturation level, gender, level of health care delivery satisfaction, and level of health-related stress; (IV) constructing a course on patient-defined culturally sensitive health care; (V) investigating the effects of teaching this course to physicians on these physicians' level of self-perceived cultural sensitivity in their health care delivery and on their patients' levels of health related stress and dissatisfaction with the health care they receive, both of which are linked to negative health outcomes; and (VI) preparing a videotaped version of the culturally sensitive health care course for national dissemination. Funding of Part II of this research project is being sought in this grant proposal. An important outcome of Part II will be inventories for patients and physicians to evaluate the level of perceived cultural sensitivity in health care received and provided respectively. These inventories will allow empirical evaluation of the need for and the impact of interventions to promote culturally sensitive health care as viewed through the eyes and hearts of the masses of individuals who are disadvantaged and/or culturally different from their health care providers.